Prognostic Factors Analysis Of Patients With Unresectable(Stage ⅢA-Ⅳ) Lung Squamous Cell Carcinoma

Objectives: The purpose of this study was to investigate the prognostic factors associated with unresectable lung squamous cell carcinoma(stage ⅢA-Ⅳ,according to the AJCC cancer staging manual,7th edition).Methods: Retrospective analysis was performed on inoperable patients(including local progression,recurrence or metastasis)hospitalized in the first affiliated hospital of China Medical University from January 2005 to June 2018.The clinicopathological information,treatment and survival follow-up data of the patients were collected.The overall survival rate of different risk groups was analyzed by Kaplan-Meier.Multivariate Cox regression analysis was used to determine the prognostic significance and explore the independent prognostic factors.Results: A total of 350 patients were enrolled.The median follow-up time of the study was 16.7 months.The median time of OS was 16.7 months(95% confidence interval(CI)= 14.6-18.8).Univariate analysis showed that the stage,first-line chemotherapy evaluation of 1.1 in solid tumors(RECIST),radiation therapy,number of systemic chemotherapy lines,CEA(carcinoembryonic antigen),CA125(cancer antigen 125),CRP(C Reactive Protein),LDH(Lactate dehydrogenase),ALB(albumin),ECOG(Eastern Cooperative Oncology Group),whether it is spread to the liver,brain,and previous surgery are ralated with overall survival(OS)in patients with advanced lung squamous cell carcinoma.Multivariate analysis showed that advanced first-line chemotherapy evaluation(HR=0.293,95%CI:0.159-0.540,P < 0.001,H R = 0.223,95 % C I: 0.120-0.413,P < 0.001),LD H(H R = 1.11 6,95%CI:0.780-1.596,P=0.002),CEA(HR=1.855,95%CI:1.361-2.528,P<0.001),C R P(H R = 1.7 1 5,9 5 % C I : 1.080-2.723,P = 0.042),E C O G(H R = 1.855,95%CI:1.063-3.239,P=0.030),liver metastasis(HR=2.453,95%CI:1.461-4.120,P=0.001),and previous surgery(HR=0.476,95%CI:0.302-0.751,P=0.001)are independent prognostic factors for OS.Conclusions: The best evaluation of first-line chemotherapy,LDH,CEA,CRP before chemotherapy,ECOG performance status,liver metastasis,and whether surgical treatment were independent prognostic factors for OS.